The FDA is demanding sole right to steer the car.
Beyond paternalism, the FDA-vs.-23andMe flap brings out another critical and unresolved matter—validity of the genomic results. Validity can be divided into two categories—technical and clinical. As far as technical, the genotyping for 23andMe is done by state-of-the-art equipment in a clinical laboratory known as the National Genetics Institute, a wholly owned subsidiary of LabCorp. In a replication experiment of 23andMe data performed in 2010, of six hundred thousand genotypes there were only eighty-five that were errors—that is a rate of 0.01 percent,54 which is as good as any academic genomics research laboratory. So the question about the accuracy of the genotyping is pretty easy to put aside.
Further, in February 2013, 23andMe scientists published, in a well-regarded, peer-reviewed, open-access journal, PeerJ, their results of the individuals who had tested positive for their BRCA tests, which are quite limited to the three mutations prevalent in Ashkenazi Jews.80 There are hundreds of mutations in the BRCA1|2 genes that may be associated with cancer—23andMe only tests for a few of the common ones via what is known as array genotyping, not sequencing.

It was through a 23andMe test that Brin learned he had a genetic mutation that increased his risk of getting Parkinson’s to somewhere between 30 and 75 percent, compared to the broader population’s risk of 1 percent. Since then, he drinks green tea and exercises a lot, two activities linked with reducing the risk of Parkinson’s.
But while it worked for Brin, 23andMe’s version of sequencing is a much simpler version of what Lukas Wartman underwent. Wartman had both his cancer and his full genome sequenced. The difference here is important. Whereas the full sequencing of a tumor is intensive and extensive, and even more so to have an entire genome sequenced, 23andMe is neither. It’s a much smaller analysis of some genes that have been linked to common diseases.
Wojcicki’s 23andMe is just one company offering do-it-yourself genomic tests, but all of them have faced criticism, specifically around their wildly variable genetic feedback.

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Though Diaz dismisses 23andMe as “a gimmick” due to its limitations, the company has developed a valuable asset in the form of the genetic material from its 900,000 customers, and it has pivoted its business model in a way that may ultimately produce both commercial and scientific victories. Through a partnership with the Michael J. Fox Foundation, 23andMe built what they called the Parkinson’s Research Community with genetic material from more than 12,000 Parkinson’s patients. This quantity of data is valuable to pharmaceutical companies developing precision medications and led to a $60 million deal for 23andMe with Genentech. As people continue to pay $99 to 23andMe for ancestor information, they will be building a database that 23andMe can commercialize for drugmakers.
Another set of concerns about the rise of medicines rooted in our genetics comes from people who worry that the development of next-generation drugs arising from genomics will reduce people’s focus on diet, environment, and lifestyle, which also damage DNA and cause cancer.

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Founded by Anne Wojcicki: Katie Hafner, “Silicon Valley Wide-Eyed over a Bride,” New York Times, May 29, 2007, http://www.nytimes.com/2007/05/29/technology/29google.html.
the company provides ancestry-related: “How It Works,” 23andMe, https://www.23andme.com/howitworks/.
It’s not a full sequencing: “About the 23andMe Personal Genome Service,” 23andMe, https://customercare.23andme.com/entries/22591668.
Since then, he drinks green tea: Elizabeth Murphy, “Do You Want to Know What Will Kill You?” Salon, October 25, 2013, http://www.salon.com/2013/10/25/inside_23andme_founder_anne_wojcickis_99_dna_revolution_newscred/.
all of them have faced: Kira Peikoff, “I Had My DNA Picture Taken, with Varying Results,” New York Times, December 30, 2013, http://www.nytimes.com/2013/12/31/science/i-had-my-dna-picture-taken-with-varying-results.html?src=recg.
In late 2013, it demanded: Chris O’Brien, “23andMe Suspends Health-Related Genetic Tests after FDA Warning,” Los Angeles Times, December 6, 2013, http://articles.latimes.com/2013/dec/06/business/la-fi-tn-23andme-suspends-tests-fda-20131205.

Through Google, Larry Page has given over $250,000 to Singularity University and has said that if he were a student, SU is where he’d want to be.67 Interestingly, his wife, Lucy Southworth, is a biologist who has written papers on aging issues, including one titled “Effects of Aging on Mouse Transcriptional Networks,” coauthored with Stanford’s Dr. Stuart K. Kim, who is a well-known aging expert and one of Larry Ellison’s award recipients.68 Sergey Brin is spreading the meme in a more personal way.
23andMe is a genomics company that was cofounded by Brin’s biologist wife, Anne Wojcicki, and has gone a long way toward popularizing the idea of personalized medicine. “Spit parties” are one of the cute marketing techniques the company uses to get the public interested in thinking about their DNA and how it might be fixed to cure disease. One high-profile party took place during New York City’s Fashion Week. Company staffers recounted the event on their blog, saying, “23andMe managed to lure a few hundred people away from the catwalks Tuesday night to consider the beauty that lies within—DNA. Our Fashion Week spit party was sort of like a Tupperware party, except instead of buying plastic containers the guests were invited to deposit a saliva sample into one.

“Biotech has gone exponential, like Moore’s law,” notes Andrew Hessel, a well-known synthetic biologist and cofounder of the Pink Army Cooperative, the world’s first cooperative biotechnology company. 45 At the time of the writing of this book, advances in biotech were moving faster than Moore’s law, according to which the number of transistors on an integrated circuit doubles approximately every two years. While the first Human Genome Project cost roughly $2.7 billion and Craig Venter spent about $70 million to sequence his own genome, by 2009 it was possible to get a genome sequenced for $5,000 and the $1,000 genome (or less) is in sight. Indeed, a partial DNA scan can already be had for only $199 at consumer genomics companies like 23andMe, and that company is using its data sets to attempt to link certain diseases to specific genes, important work on the way toward individually tailored pharmaceuticals and cures.46
Given the speed at which prices for new technology are shooting downward, particularly in biotechnology, the time horizon between longevity technology adoption by the rich and then by the poor within developed countries will probably shrink enough that few will consider taking up arms or unduly involving the state in repairing their bodies.

All the Neanderthal DNA sequences are available as online databases, and nowadays the latest sequencing technologies mean that everyone can have their genome scanned (though not fully sequenced) and analysed for many different things. 23 and Me is one such company, and I had my genome parsed with them, the results of which are discussed in more detail later on. But one of the things that emerges out of these personal genomics is what Neanderthal DNA you carry. For me, a solid 2.7 per cent of my total DNA is drawn from these people (which rather uninterestingly, according to their data, is bang on average for most Europeans; academic results suggest that this is an overestimate, and the proportion is lower in Europeans). Three billion letters of DNA make up my genome, and based on the 23 and Me data, around 81 million of those come from Neanderthals, spread in chunks of varying size across my twenty-three pairs of chromosomes.

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So, for example, the fact that my sequence came back without a SNP associated with Parkinson’s disease does not mean I will not get Parkinson’s disease. It means that my chance of getting Parkinson’s disease with this particular gene variation is average. Conversely, according to 23andMe, I have a genotype that is of higher risk than most people for developing Alzheimer’s disease. That does not mean that I will get Alzheimer’s disease, it means that the chance I will is slightly higher than most people. Similarly, if you don’t have that genotype, you are not immune to Alzheimer’s. Knowing my own personal risk neither bothers me, nor has prompted a change in my behaviour at all.
For the physical characteristics, they are kind of interesting, in an instantly forgettable way. In my 23 and Me readout, it confidently says that my eyes are ‘likely brown’ due to the presence of an A in one version of a gene called HERC2, and a G in the other.

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The Y is a tiny proportion of the total DNA I possess, and in fact less than the amount of DNA that I and most Europeans have inherited from Neanderthals, at least according to the rival DNA testing company 23andMe. To label my ‘ancestral type’ as this Germanic warrior with all his gliding across the frozen Rhine in unfashionable trousers is absurd. By simple percentages in my genome, I am more Neanderthal than this bearded character.
Another tiny bit is from my mother’s lineage, the mitochondrial genome, which was not on the database of BritainsDNA at the time of my test, as these types of company generally add data as they add customers. 23 and Me report that it is most common in India – again, not a tremendous surprise given that my mother is Indian. The mitochondrial genome harbours just 37 genes, and the Y chromosome 458.

., exercise and vitamin consumption) as a result.140 Other news accounts continue to chronicle how individuals are seeking their own genomic data and finding it useful—for example, to learn about Alzheimer’s and heart disease risk.141
As a result of paternalistic purview, and no clear government policies for the preventive medicine era, US-based consumer genomics services have closed (deCODEme142), directed their services exclusively toward a physician-permissioning model (Pathway Genomics, Navigenics), or been forced to greatly curtail their consumer-targeted services (23andMe143). In response, blockchain-based genomic services could be an idea for providing low-cost genomic sequencing to individuals, making the data available via private key.
One of the largest current transformational challenges in public health and medicine is moving from the current narrowband model of “having only been able to treat diagnosed pathologies” to a completely new data-rich era of preventive medicine for which the goal is maintaining, prolonging, and enhancing baseline health.144 Such a wellness era is now beginning to be possible through the use of personalized big data as predictive information about potential future conditions.

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One example of this is DNA.bits, a startup that encodes patient DNA records to the blockchain, and makes them available to researchers by private key.151
However, it is not just that private health data research commons could be established with the blockchain, but also public health data commons. Blockchain technology could provide a model for establishing a cost-effective public-health data commons. Many individuals would like to contribute personal health data—like personal genomic data from 23andMe, quantified-self tracking device data (FitBit), and health and fitness app data (MapMyRun)—to data research commons, in varying levels of openness/privacy, but there has not been a venue for this. This data could be aggregated in a public-health commons (like Wikipedia for health) that is open to anyone, citizen scientists and institutional researchers alike, to perform data analysis. The hypothesis is that integrating big health data streams (genomics, lifestyle, medical history, etc.) and running machine learning and other algorithms over them might yield correlations and data relationships that could be helpful for wellness maintenance and preventive medicine.152 In general, health research could be conducted more effectively through the aggregation of personal health record data stored on the blockchain (meaning stored off-chain with pointers on-chain).

Nevertheless, personalized genome sequencing will help to usher in a new era in which medicine is increasingly tailored to an individual.
Retail genomics
Named after the fact that everyone has 23 pairs of chromosomes, 23andMe is a private Californian company that allows ordinary individuals to find out about and understand their personal genomics. The fact that the company is backed financially by Google might seem rather odd to some people, but if Google’s aim is to organize the world’s information, they will clearly need everyone’s DNA. Products available from 23andMe include ancestry testing and healthcare screening, especially with regard to how an individual’s genes might impact on their future health and healthcare costs.
The Google-backed biotech company 23andMe was offering individuals gene sequencing for $999 in 2011. At the time of writing (June 2012) the cost had fallen to $299.

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At the time of writing (June 2012) the cost had fallen to $299. A decade earlier this would have cost close to $10,000, while James Watson, the codiscoverer of DNA and one of the people behind the Human Genome Project, paid around $2 billion to work out how to make sequencing work. Interestingly, 23andMe plugs into the idea of crowd-sourcing data, too, by sending regular questionnaires to thousands of users asking about them about, for example, specific food allergies. When the responses to such surveys are matched against known genetic information they can potentially find the causes of certain traits in a matter of months rather than years and for minimal cost.
Power to the patient What are the main outcomes of being able to access this type of information? For one thing, more accurate diagnosis of common conditions. It also opens the way for individuals to be prescribed certain drugs or to be warned against certain known risk factors or environments associated with particular conditions.

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It’s challenging to identify more than links between biology and behavior because of the difficulty of separating them from environmental variables, such as drugs and alcohol or poor diet. Expect the controversy to develop rapidly alongside our knowledge of the workings of the human brain.
the condensed idea
Genetic prophesy
timeline
1997 Release of the movie Gattaca about genetic enhancement
2008 Knome offers genome sequencing to individuals for $350,000
2009 Knome drops its price to $99,500
2012 23andMe offers gene sequencing for $299
2018 Cost falls to $49 via Walmart
2020 Hospitals and insurers offer free genome profiling
2030 Google dating based upon ideal DNA profiles
2050 DNA database creates human underclass
22 Regenerative medicine
Is it possible to prevent or reverse the aging process, perhaps by fiddling with tired tissues and cells, or even growing new organs inside a laboratory?

Because DNA’s component parts love to snap together in predetermined ways, copies of my own genetic code would have latched on to these probes with varying degrees of connectedness, letting the company know which markers I possess and allowing them to suggest what these might mean for my health. Because our understanding of the interplay of our genes and environment is still evolving, 23andMe attaches confidence ratings to each finding (the higher the rating, the more secure they feel in their analysis).
Because I have one genetic marker that a 2007 German study suggests is linked to Tourette’s syndrome, 23andMe let me know I might have an elevated chance of the condition, although they give this a confidence rating of one (out of four). In the two-star category there are potential elevated risks of ‘essential tremor,’ ‘Hashimoto’s thyroiditis’ and ‘Sjögren’s syndrome. The company gives a confidence rating of three to its analysis that I have higher-than-average risks of asthma, atopic dermatitis and chronic lymphocytic leukemia.

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Another is emerging from Google founder Sergey Brin, who is funding a pattern-finding project to assist in the cure for Parkinson’s disease (which analysis of his DNA tells him he has a 30–75 per cent chance of developing). ‘Generally the pace of medical research is glacial compared to what I’m used to in the Internet,’ Brin says. ‘We could be looking lots of places and collecting lots of information. And if we see a pattern, that could lead somewhere.’ So he recruited a group of 10,000 Parkinson’s sufferers, had the company 23andMe (which is largely funded by Google) run their DNA, and set out to find links. It’s one of the many examples Kurzweil cites of information technology ‘invading one field after another.’
Sitting in front of Ray Kurzweil, I’m getting just what I came for. I’m becoming disenthralled from my inclination to think linear. We must understand the power of the exponential, he urges. If we don’t, progress will outrun us, and our personal decisions will be hopelessly out of step with an unfolding reality.

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Just behind me is the spot where in 1795 the British Admiralty erected its optical telegraph station to pass signals down the line between coast and capital. Communications have come a long way since 1795. On my lap is a computer, battered and grubby from long hours on the road. Using my mobile phone as a wireless modem I am surfing the Internet. In particular I am looking at my ‘genetic profile’ having just logged on to the website of 23andMe, the Google-funded personal genomics company that Sergey Brin has been using for his Parkinson’s research.
Several weeks ago, the company sent me a plastic tube, which I filled with saliva and returned to its laboratories. From this the company extracted cheek cells, out of which they stripped my DNA to be duplicated many times over. These synthetic copies of my DNA were then chopped up and applied to a ‘DNA chip,’ a glass slide with millions of DNA ‘probes’ on its surface.

As a result, a new industry of individual gene sequencing is cropping up. Since 2007 the Silicon Valley startup 23andMe has been analyzing people’s DNA for only a couple of hundred dollars. Its technique can reveal traits in people’s genetic codes that may make them more susceptible to certain diseases like breast cancer or heart problems. And by aggregating its customers’ DNA and health information, 23andMe hopes to learn new things that couldn’t be spotted otherwise.
But there’s a hitch. The company sequences just a small portion of a person’s genetic code: places that are known to be markers indicating particular genetic weaknesses. Meanwhile, billions of base pairs of DNA remain unsequenced. Thus 23andMe can only answer questions about the markers it considers. Whenever a new marker is discovered, a person’s DNA (or more precisely, the relevant part of it) has to be sequenced again.

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Working with a subset, rather than the whole, entails a tradeoff: the company can find what it is looking for faster and more cheaply, but it can’t answer questions that it didn’t consider in advance.
Apple’s legendary chief executive Steve Jobs took a totally different approach in his fight against cancer. He became one of the first people in the world to have his entire DNA sequenced as well as that of his tumor. To do this, he paid a six-figure sum—many hundreds of times more than the price 23andMe charges. In return, he received not a sample, a mere set of markers, but a data file containing the entire genetic codes.
In choosing medication for an average cancer patient, doctors have to hope that the patient’s DNA is sufficiently similar to that of patients who participated in the drug’s trials to work. However, Steve Jobs’s team of doctors could select therapies by how well they would work given his specific genetic makeup.

But had the hospital known Bates’s condition ahead of time, the incident, which could have easily killed her or resulted in serious brain damage, could have been avoided.21 Thanks to services like 23andMe, many of us will be able to head off such occurrences very soon. For $200, the company takes a saliva sample from you by mail and returns a detailed analysis of your DNA, its algorithm teasing out a variety of fascinating factors, from your ancestry to your health risks and potential reactions to medications. To be sure, some doctors and health experts say that 23andMe’s tests offer no useful information and that consumers should save their money. And some states, including New York, have ordered 23andMe and similar services to get approval from the state’s health department, declaring their tests to be medical and therefore open to regulation. Such regulation is “appallingly paternalistic,” says 23andMe, adding that people have a right to information contained within their own genes.

Indeed, Brin premises his information-gathering strategy on the understanding that rich and poor alike can have defective Parkinson’s genes.
Brin uses the testing company 23andMe, named after the 23 pairs of chromosomes in the human genome and cofounded by Brin’s wife, to find the genetic roots of Parkinson’s. 23andMe gives its customers, who include this author, an informative but incomplete genetic profile listing their relative risks of getting different types of disease. I have learned, for example, that, compared to the average adult male of my ethnic group, my genes decrease the odds I will get Alzheimer’s but raise the likelihood of my someday contracting coronary heart disease.
Brin subsidizes the purchase of 23andMe services for Parkinson’s patients in the hope of convincing many of them to sign up.313 He also requests that the company’s customers fill out a survey asking if they or any members of their family have Parkinson’s or Parkinson’s symptoms, such as balance problems.

Many medical devices are starting to be Internet-enabled, collecting and reporting a variety of biometric data. There are already—or will be soon—devices that continually measure our vital signs, our moods, and our brain activity. It’s not just specialized devices; current smartphones have some pretty sensitive motion sensors. As the price of DNA sequencing continues to drop, more of us are signing up to generate and analyze our own genetic data. Companies like 23andMe hope to use genomic data from their customers to find genes associated with disease, leading to new and highly profitable cures. They’re also talking about personalized marketing, and insurance companies may someday buy their data to make business decisions.
Perhaps the extreme in the data-generating-self trend is lifelogging: continuously capturing personal data. Already you can install lifelogging apps that record your activities on your smartphone, such as when you talk to friends, play games, watch movies, and so on.

We’ve used sprints for prioritization, for marketing strategy, even for naming companies. Time and time again, the process brings teams together and brings ideas to life.
Over the past few years, our team has had an unparalleled opportunity to experiment and validate our ideas about work process. We’ve run more than one hundred sprints with the startups in the GV portfolio. We’ve worked alongside, and learned from, brilliant entrepreneurs like Anne Wojcicki (founder of 23andMe), Ev Williams (founder of Twitter, Blogger, and Medium), and Chad Hurley and Steve Chen (founders of YouTube).
In the beginning, I wanted to make my workdays efficient and meaningful. I wanted to focus on what was truly important and make my time count—for me, for my team, and for our customers. Now, more than a decade later, the sprint process has consistently helped me reach that goal. And I’m superexcited to share it with you in this book.

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Adrian Canoso designed the Relay robot on page 14.
Heidi Qiao volunteered to sit for the customer test photos on pages 203 to 204.
All other photos are by either Jake Knapp, Braden Kowitz, or John Zeratsky.
Image postproduction by Braden Kowitz.
Illustrations by Jake Knapp.
JAKE KNAPP created the Google Ventures sprint process and has run more than a hundred sprints with startups such as 23andMe, Slack, Nest, and Foundation Medicine. Previously, Jake worked at Google, leading sprints for everything from Gmail to Google X. He is among the world’s tallest designers.
JOHN ZERATSKY has designed mobile apps, medical reports, and a daily newspaper (among other things). Before joining Google Ventures, he was a design lead at YouTube and an early employee of FeedBurner, which Google acquired in 2007.

Food and Drug Administration’s cumbersome approval process. As long as an application and sensor are sold as a patient’s reference tool rather than for a doctor’s use, they don’t need approval. But these applications and attachments increasingly are replacing real medical opinions and tests.
Innovators’ path to market isn’t entirely obstacle free. The FDA was able to quickly and easily ban the upstart company 23andMe from selling its home genetics test kits to the public, though it later partly revised its decision.2 Uber has been fighting regulatory battles in Germany and elsewhere, largely at the behest of the taxi industry.3 But the services these two companies provide are nearly inevitable now due to the huge public support they have received as a result of the tremendous benefits they offer in their specific realms.

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When a genome test tells you that you are predisposed to a disease, you could take it very seriously and become demoralized, when in fact the factors that lead to disease are much more complex and often include aspects under our control. The readouts that consumer devices produce could lead people who don’t have experience in medicine to make poor decisions. And the A.I. doctors won’t have real compassion for at least another decade, maybe two.
A larger concern is security and privacy. Genome tests will soon become as common as blood tests, and protecting our genomic data won’t be easy. The company 23andMe ran afoul of regulators because it was telling people what diseases they might be predisposed to. As I mentioned earlier, the issue here was the accuracy of the analysis and what people might do with the information. The bigger question, however, is what businesses may do with genomic data. Genetic-testing companies typically have contractual clauses that let them use and sell their clients’ genetic information to third parties.

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The effort to sequence a human genome was a long and costly one. Started by the government-funded Human Genome Project and later augmented by Celera Genomics and its noted scientist CEO, Craig Venter, the sequencing spanned more than a decade and cost nearly $3 billion. Today, numerous companies are able to completely sequence your DNA for around $1,000, in less than three days. There are even venture-backed companies, such as 23andMe, that sequence parts of human DNA for consumers, without any doctor participation or prescription, for as little as $199.
We can expect the price of DNA sequencing to fall to the cost of a regular blood test in the early 2020s and, shortly thereafter, to cost practically nothing. Again, what makes this possible is that the computers that sequence DNA are becoming faster and more powerful in parallel with development of the microprocessors that power them, which double in speed and halve in price every eighteen to twenty-four months.

In the comments, Chris Cranley took off on Godin’s idea and suggested that just as smarter products may need less insurance, the same may be said of smarter people: “If I knew how to avoid problem X, I would not insure against it.” Education and information become insurance against insurance. Godin took this line of thinking to its extreme when he speculated about opportunities not just for smarter people but—genetically speaking—healthier people as determined by 23andMe, a service that analyzes users’ DNA. (Founded by Brin’s wife, Anne Wojcicki, 23andMe discovered his Parkinson’s gene. Google invested in the company.) Godin said:
And while some may not like it, what happens when 23andMe gets a lot smarter and the healthiest gene pool starts their own life insurance coop?
U.K. business journalist James Ball agreed with me that insurance is “a glorified betting market” where insurance providers “offer odds against certain outcomes—adverse outcomes—and we pay up the stake.

“As some put it, personal data will be the new ‘oil’ — a valuable resource of the 21st century. It will emerge as a new asset class touching all aspects of society.”
The idea of data as a currency is still in its infancy, as Strata Conference chair Edd Dumbill has emphasized. The Locker Project, which provides people with the ability to move their own data around, is one of many approaches.
The growth of the Quantified Self movement and online communities like PatientsLikeMe and 23andMe validates the strength of the movement. In the U.S. federal government, the Blue Button initiative, which enables veterans to download personal health data, has now spread to all federal employees and earned adoption at Aetna and Kaiser Permanente.
In early 2012, a Green Button was launched to unleash energy data in the same way. Venture capitalist Fred Wilson called the Green Button an “OAuth for energy data.”

But even though he was raised as a Jew and attended Hebrew school for a few years, he was nonpracticing, did not have a bar mitzvah, and was put off by traditional Jewish celebrations, which he once told an Israeli reporter he “associated with getting lots of gifts and money, and I was never comfortable with that.” When he was married on an island in the Bahamas in May of 2007 to Anne Wojcicki, cofounder of 23andMe, a genetics research company, the couple stood in bathing suits under a chuppah, the traditional Jewish wedding canopy, but no rabbi officiated.
Then, as now, he was uncomfortable with introspection. Asked by the same Israeli reporter if it was a coincidence that his wife was Jewish, he said, “I believe there are lots of nice non-Jewish girls out there. My wife is, I guess, half Jewish.”
So was it a coincidence, the reporter pressed, that his wife was half Jewish?

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He ruthlessly guards his time, and can treat those who ask him to make a speech or meet reporters as if they were thieves trying to steal his time. A longtime Google employee describes Page this way: “Larry is like a wall. He analyzes everything. He asks, ‘Is this the most efficient way to do this?’ You’re always on trial with Larry. He always pushes you.”
While Brin is more approachable than Page, he, too, can be awkward around strangers. His wife Anne Wojcicki’s company, 23andMe, was feted at a fashionable cocktail party in September 2008 that was cohosted by Diane von Furstenberg and her husband, Barry Diller, Wendi and Rupert Murdoch, and Georgina Chapman and her husband, Harvey Weinstein. The event was held at Diller’s Frank Gehry-designed IAC headquarters in Manhattan. Brin appeared wearing a dark crewneck sweater and gray Crocs. He and Google are investors in her company and he is openly proud of her work.

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Al Gore was to conclude the conference by interviewing Page and Brin. The three men chatted on stage for a few minutes when Page interrupted to say that Brin wanted ten minutes to share something. Brin stepped to a microphone and riveted the audience for about ten minutes with a precise, impersonal account of his mother’s recent diagnosis of Parkinson’s disease. He explained that his wife, Anne Wojcicki, had cofounded 23andMe to study genetics, including the genetics of Parkinson’s. He said the evidence of a genetic link to Parkinson’s was at first slight, but studies had recently unearthed one gene, LRRK2, in particular a mutation known as G2019S, that in some ethnic groups creates a familial link through which the disease travels.
Brin said he had dug deeper, reading genetics journals, searching for pieces of DNA shared with relatives.

The idea is for Google Fit to feed the Baseline Study with the data it needs.30
Yet companies such as Google want to go much deeper than wearables. The market for DNA testing is currently growing in leaps and bounds. One of its leaders is 23andMe, a private company founded by Anne Wojcicki, former wife of Google co-founder Sergey Brin. The name ‘23andMe’ refers to the twenty-three pairs of chromosomes that contain our genome, the message being that my chromosomes have a very special relationship with me. Anyone who can understand what the chromosomes are saying can tell you things about yourself that you never even suspected.
If you want to know what, pay 23andMe a mere $99, and they will send you a small package with a tube. You spit into the tube, seal it and mail it to Mountain View, California. There the DNA in your saliva is read, and you receive the results online.

Privacy is obviously an issue, but the ability to create databases of symptoms and diseases and drugs and side effects can be enormously valuable, with so much of the Intelligence at the Edge, with doctors and especially with patients. The biggest nearterm gain will probably be seen by networking researchers. Sage Bionetworks allows researchers around the world to contribute to and draw from an open database of clinical and molecular data so they can “build innovative new dynamic disease models.” But it’s not just for scientists; 23andMe analyzes your DNA and then compares it with others’ to identify your potential predisposition to various diseases. Lots of issues need to be worked out, not the least of which is, what does “your DNA suggests a 27 percent probability of contracting liver cancer” even mean? The Personal Genome Project, meanwhile, lets individuals upload their DNA sequencing for researchers to probe, privacy be damned.

Such issues need to be resolved sooner rather than later.
Consider a company formed with the promise of offering customers interesting information about their thoughts and/or predictive information about brain diseases they might be at risk of acquiring. Many such companies, some more legitimate than others, are operating now in the sphere of genomics. Some are huge and have proven profitable, like deCODE and 23andMe. Others are small and often make claims that are on the fringes of genomic science. Building on preliminary and incomplete information coming out of the brain mapping projects and related research, we can predict with certainty that new “brain diagnostic,” “truth assessment,” and “brain detective companies” will begin to proliferate on the web and elsewhere. The emergence of companies that purport to be able to conduct neuromarketing without much in the way of evidence to ground their claims shows what is likely to be in store in short order regarding “truth” analyses.

As a daily jogger, she’d be inhaling a lot more pollution than most people, and she figures her genes have already been restyled just by growing up among the master trailblazers of the Human Age.
But she is tempted to read the book of her genes, and discover more about her lineage and genetic biases. For a truly personal profile, all our redhead would need is a vial of her blood and between $100 and $1,000. Such companies as Navigenics or 23andMe will gladly provide a glimpse of her future, a tale still being written but legible enough for genetic fortune-telling. She may have a slightly higher than normal risk of macular degeneration, a tendency to go bald, a gene variant that’s a well-known cause of blood cancer, maybe a different variant associated with Alzheimer’s, the family bane. If she read the report herself, she might not handle that information well.

One acquaintance removed almost every food from his diet—“I’m allergic to them all!”—without realizing that food allergy testing is notoriously error-prone. If you get an alarming result, repeat the test. If you have the budget, consider using a different lab or, better still, sending two identical samples to the same lab under different names. I did the latter with several tests, including 23andMe, to ensure the results were consistent. 23andMe passed, but many others did not. Get a second opinion before doing anything drastic.
I owe special thanks to Dr. Justin Mager for helping me navigate the world of testing.
THE MENU
Insurance will often cover the first one or two comprehensive tests you have performed, and I encourage you to speak with your doctor about this option.
I prefer to keep my testing activities (and results) out of insurance files and usually pay with a credit card.

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Good pre-dinner motivation for overfeeding.
Arthur Jones Collection (www.fourhourbody.com/jones) This site, compiled by Brian Johnston, is a collection of the writing and photographs of the legendary Arthur Jones, including the original Nautilus Bulletins, “The Future of Exercise,” and unpublished works.
End of Chapter Notes
8. I’ve since confirmed this finding with three separate genetic profiles through 23andMe (two tests with different names to ensure consistent results) and Navigenics.
9. I’ve since learned to worry less about cholesterol if HDL is high enough and triglycerides are low enough.
10. Compiled with a combination of the lowest and highest measurements from both locations.
11. To give my adrenal glands and adrenergic receptors a rest, I didn’t consume NO-Xplode on Sundays.
12. I recommend the squat for those who have access to a Safety Bar, which provides a yolk-like shoulder harness.
13.

Perhaps we’d join Miinome, “the first member-controlled, portable human genomics marketplace,” where you can sell your genomic information and receive deals from retailers based on that same information. (Again, I think back to HSBC’s “Your DNA will be your data” ad, this time recognizing it not as an attempt at imparting a vaguely inspirational, futuristic message, but as news of a world already here.) That beats working with 23andMe, right? That company already sells your genetic profile to third parties—and that’s just in the course of the (controversial, non-FDA-compliant) testing they provide, for which they also charge you.
Tellingly, a version of this proposal for a data marketplace appears in the World Economic Forum (WEF) paper that announced data as the new oil. Who could be more taken with this idea than the technocrats of Davos?

There, a medical Watson could diagnose diseases, suggest treatments that have proven successful, and steer doctors away from those that have led to problems. Such analyses could save lives, Jasinski said. ”We kill a hundred thousand people a year from preventable medical errors.”
In fact, the potential for next-generation computers in medicine stretches much further. Within a decade, it should cost less than $100 to have an individual’s entire genome sequenced. Some people will volunteer to have this done. (Already, companies like 23andMe, a Silicon Valley startup, charge people $429 for a basic decoding.) Others, perhaps, will find themselves pressed, or even compelled, by governments or insurers, to submit their saliva samples. In either case, computers will be studying, correlating, and answering questions about growing collections of this biological information.
At the same time, we’re surrounding ourselves with sensors that provide streams of data about our activities.

The machine can handle various tasks, but an important one is gene sequencing. At Mount Sinai, they are sequencing entire genomes—looking at all three billion nucleotides, the basic structural unit of DNA. Within that deluge of nucleotides, scientists have identified about ten million DNA segments called SNPs (pronounced snips), for single nucleotide polymorphisms, that have been linked to diseases in research studies. Consumer gene-testing services, like 23andMe, look at fewer than a million SNPs. At Mount Sinai, the ambitions are larger. They want to see the whole picture, the entire genome sequenced. To really advance research and treatments at Mount Sinai, it will have to do a lot of it, very quickly. The goal, Kovatch says, is to compress the time it takes from days down to an hour. She has named her supercomputer Minerva, for the Roman goddess of wisdom.

You could even spot an occasional Dilbert cartoon on a cubicle. Many cheeky activities that had once seemed so refreshing began to assume an aura of calculation when they became routine. How many scavenger hunts can you attend before it becomes a chore?
Page and Brin themselves had grown in the decade since they founded Google. Both were now married and within a year of each other fathered sons. Brin’s wife, Anne Wojcicki, was a cofounder of 23andMe, a company involved in personal DNA analysis. Brin defied corporate propriety when he shifted his personal investment in the firm to a company one. Google’s lawyers made sure the transaction passed formal muster.
The normally gregarious Brin could turn icy when an unfamiliar person referred to his private life—for example, when a reporter offered congratulations at a Q and A at the Googleplex soon after his wedding, he changed the subject without acknowledging the remark.

…

But Brin was genuinely open and emotional during a session of the 2008 Google Zeitgeist. Brin put aside talk of commerce to explain that he had examined his own genome with the help of his wife’s DNA-testing enterprise. Since his mother, Eugenia, had previously been diagnosed with Parkinson’s disease, he had looked specifically for an anomaly on the genetic location known as LRRK2—and discovered a mutation known as G2019S, associated with Parkinson’s. His mother, also a 23andMe customer, had the same mutation. (“She’s okay,” he assured everyone. “She skis.”) Brin immediately began researching the implications of this signal; “I found it fairly empowering,” he said. He also became involved with charities trying to find a cure for Parkinson’s, such as the Michael J. Fox Foundation. He showed rare public emotion as he thanked his wife for her help, support, and genomic expertise.

Indeed, its emergence as one of the top financiers of startups may be a first for a corporate venture fund. While tech companies have long backed startups, their venture arms have a history of terribly subpar returns, mainly because there was no real independence from the parent company.
Google Ventures has invested in more than 225 portfolio companies encompassing all stages and industry sectors, including such rising stars as Uber, Nest, 23andMe, Cloudera, Optimizely, TuneIn, Homejoy and High Fidelity. As a result of its many successes, Google Ventures opened a London office in 2014, with $100 million to invest in European startups.
Although Google provides the funds for Google Ventures, invested companies don’t have to benefit Google. That means portfolio companies stay independent and can be acquired by competitors. A downside of this structure, of course, is that Google Ventures might well remain in the dark about potential deals being undertaken by its parent company.

With its mobile sensors and apps and visualizations, this movement is tracking and measuring exercise, sleep, alertness, productivity, pharmaceutical responses, DNA, heartbeat, diet, financial expenditure—and then sharing and displaying its findings for greater collective understanding. It is using its tools for clustering, classifying, and discovering rules in raw data, but mostly it is simply quantifying that data to extract signals—information—from the noise.
The cumulative rewards of such thinking will be altruistic rather than narcissistic, whether in pooling personal data for greater scientific understanding (23andMe) or in propagating user-submitted data to motivate behavior change in others (traineo). Indeed, as the work of Daniel Kahneman, Daniel Gilbert, and Christakis and Fowler demonstrate so powerfully, accurate individual-level data tracking is key to understanding how human happiness can be quantified, how our social networks affect our behavior, how diseases spread through groups.
The data is already out there.

Instead of money, ‘peer producers who create the stuff gain credit, status, reputation, enjoyment, satisfaction and experience’. People are willing to share their photographs on Flickr, their thoughts on Twitter, their friends on Facebook, their knowledge on Wikipedia, their software patches on Linux, their donations on GlobalGiving, their community news on Craigslist, their pedigrees on Ancestry.com, their genomes on 23andMe, even their medical records on PatientsLikeMe. Thanks to the internet, each is giving according to his ability to each according to his needs, to a degree that never happened in Marxism.
This catallaxy will not go smoothly, or without resistance. Natural and unnatural disasters will still happen. Governments will bail out big corporations and big bureaucracies, hand them special favours such as subsidies or carbon rations and regulate them in such a way as to create barriers to entry, slowing down creative destruction.

Researchers are creeping towards printing entire organs.46 This matters—on average, twenty-one people a day die in the United States, and just under three in the United Kingdom, waiting for spare organs.47
Increasing computational power has meant that certain fields, previously conceivable in theory but impossible in practice, are now thriving. Genomics, the science of scanning a patient’s DNA to personalize medical treatment and anticipate future disease, is one example. In 2007 it would have cost around $10 million to read a human genome. Now it costs a few thousand dollars.48 Companies like 23andMe, Navigenics, and deCODE offer commercial testing services from $99.49 In the field of ‘genome editing’, scientists search for problematic genes and actively intervene to change or remove them. Nanomedicine, the use of nanotechnology in a medical setting, is another field. Nobel Laureate Richard Feynman’s seventy-year-old prediction that we might one day ‘swallow the surgeon’50 has come true—there are already small nanobots that are able to swim through our bodies, relaying images, delivering targeted drugs, and attacking particular cells with a precision that makes even the finest of surgeons’ blades look blunt.

Quickly, the cost of sequencing a full human genome fell from about $3 billion in 2000 to $1 million in 2006 and to $100,000 by 2008. Then, in 2008, something astounding happened: the creation of so-called next-generation sequencers caused the price of decoding human genomes to plummet. As a result, improvements in genetic sequencing outpaced advances in computing by five times. By 2014, we had reached the age of the $1,000 whole-genome mapping. Companies such as 23andMe were offering home DNA test kits to the general public for $99 or less, allowing them to merely spit into a plastic tube, ship it off via a prepaid envelope, and a week or two later receive health, ancestry, and genealogy results online.
Looking forward, the trend in DNA sequencing suggests that in a few years the price of DNA sequencing will drop to the point that some company will pay to sequence new customers, reducing the out-of-pocket costs to free—a widely used business model in computer technology.

Advances in human whole genome testing will likely become available by 2014 so that every person’s entire complement of genes can be scanned and known at his or her physician’s office for as little as $1,000 (National Cancer Institute 2009). Once whole genome testing is perfected we will all learn what even our randomly conferred genes may predispose us to do and from what future ills we are likely suffer. Already, my relatively inexpensive genotype scan from 23andMe tells me that I have alleles that give me a somewhat greater risk of developing celiac disease, a lower risk of rheumatoid arthritis, and a gene variant that some studies suggest can increase my risk of substance abuse (of both alcohol and “street” drugs) fourfold. With ­accumulation of genetic understanding, human freedom will then properly be seen as acting to overcome these predispositions, much like a former alcoholic can overcome his thirst for booze.